Organization
NORTHEAST BEHAVIORAL SERVICES, INC
Active
Parent organization
DAVID A SACK, MD TN PC
Other names
Park Bench Professional
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVID A SACK, MD TN PC
Authorized official
CHERYL MAPLESDEN CPC, CHC, CHPC (DIRECTOR, REVENUE CYCLE)
(615) 510-3708
Entity
Organization
Contact information
Practice address
421 BETHEL RD, SOMERS POINT, NJ 08244-2081
(615) 567-7256
Mailing address
PO BOX 670521, DALLAS, TX 75267-0521
(615) 567-7256
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
25MA04602100
NJ
2084P0800X
Psychiatry Physician
Primary
25MB06828200
NJ
363LF0000X
Family Nurse Practitioner
26NJ00062700
NJ
Other
Enumeration date
04/11/2016
Last updated
04/11/2016
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